Inverted T-shape free gingival graft for root coverage in Cairo’s RT II recession in mandibular incisors

Diastema and extensive gingival recession in the mandibular anterior region provide both functional and cosmetic challenges. In order to produce adequate keratinized tissue width and dependable root covering, such defects sometimes require advanced surgical methods. When there are simultaneous vertical and horizontal tissue shortages, traditional free gingival graft (FGG) arrangements may not be able to adapt sufficiently. An inverted T-shaped FGG design can be used to overcome these limitations by simultaneously covering the exposed root surface and improving the interdental tissue span. This article describes a case study using an inverted T-shaped free gingival graft to cover the roots of advanced recession defects in the mandibular anterior teeth with diastema. In order to increase stability, vascularization, and aesthetic integration, a graft with a horizontal arm to bridge the interdental gap and a vertical portion to treat the recession depth is harvested. At follow-up, the patients showed excellent results, such as increased keratinized tissue width, considerable root coverage, and harmonious gingival outlines. The promise of the inverted T-shaped FGG as a reliable and aesthetically pleasing solution in challenging recession scenarios complicated by diastema is highlighted in this case study.